Reflections by award-winning maritime historian Joan Druett, author of many books about the sea

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Thursday, April 20, 2017

Life-saving medieval medicine

A hero of mine is John Woodall, who featured boldly in my story about sea surgeons on whaleships, Rough Medicine.

Born about 1570, Woodall was apprenticed to a London barber-surgeon at about the age of 16, and served in Normandy during one of the interminable wars of the time. In 1599, having been inured by then to the sight of blood and dismembered limbs, he returned to London to become a member of the Company of Barber-Surgeons, earning the right to have a red-and-white striped pole (symbolizing blood and bandages) outside his establishment. He went to the Netherlands after that, to learn chemistry by working with an apothecary-alchemist. His adventurous and rather gory career carried him on through a plague and a voyage in the tropics, to an appointment as the Surgeon-General of the East India Company.

It was a job he held down for thirty years, and is important because (a) he was the first man to devise and stock a medical chest for surgeons at sea and (b) because he wrote the first manual in history for seafaring medics, The Surgions Mate, which was first published in 1617.

It is an odd and intriguing volume, remarkable for its kindly attitude to ailing seamen, and its very strange recipes. It's impossible not to wince at the prospect of being dosed, for instance, with "Worme-wood Water" (absinthe, a poison), which he considered "gratefull to the stomacke," in that it "consumeth and breaketh winde mightily, killeth the wormes" -- but, according to a marvellous paper in The Smithsonian, medieval medicine such as practised by Woodall and his contemporaries could provide a solution to modern antibiotic-resistant bugs.

"Medieval medical books could hold the recipe for new antibiotics," writes Erin Connolly. As she goes on to say, she is "part of the Ancientbiotics team,
a group of medievalists, microbiologists, medicinal chemists,
parasitologists, pharmacists and data scientists from multiple
universities and countries. We believe that answers to the antibiotic
crisis could be found in medical history. With the aid of modern
technologies, we hope to unravel how premodern physicians treated
infection and whether their cures really worked.

"To that end, we are compiling a database of medieval medical recipes.
By revealing patterns in medieval medical practice, our database could
inform future laboratory research into the materials used to treat
infection in the past. To our knowledge, this is the first attempt to
create a medieval medicines database in this manner and for this
purpose."

An exciting discovery was a recipe for a salve for a stye in the eye. As Connolly describes, "In 2015, our team published a pilot study on a 1,000-year old recipe called Bald’s eyesalve from “Bald’s Leechbook,”
an Old English medical text. The eyesalve was to be used against a
“wen,” which may be translated as a sty, or an infection of the eyelash
follicle.

"A common cause of modern styes is the bacterium Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus (or MRSA)
is resistant to many current antibiotics. Staph and MRSA infections are
responsible for a variety of severe and chronic infections, including
wound infections, sepsis and pneumonia.

"Bald’s eyesalve contains wine, garlic, an Allium species
(such as leek or onion) and oxgall. The recipe states that, after the
ingredients have been mixed together, they must stand in a brass vessel
for nine nights before use.

"In our study, this recipe turned out to be a potent antistaphylococcal agent, which repeatedly killed established S. aureus biofilms
– a sticky matrix of bacteria adhered to a surface – in an in vitro
infection model. It also killed MRSA in mouse chronic wound models."

Interestingly, the method laid out in the Leechbook had to be followed exactly. It seems that though we now deride those old practitioners for their reliance on bloodletting and balancing the "humors," they often did know what they were doing -- and the lore of the old barber-surgeons, apothecaries and alchemists of the medieval past is still of value today.